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保育所保育指針改定に係る議論を踏まえて考察する担当制の意義
Get PDFapplication/pdfThis study examines the significance of the assignment system adopted in infant care from the perspective of the changes in the Guidelines for Nursery Care and Education for Day Nurseries. It obtains fundamental feedback from the childcare field. The study focused on minutes, summaries, and materials from the Ministry of Health, Labour and Welfare’s Social Security Council, Child Committee, and Nursery Care Specialist Subcommittee, particularly examining sections related to the assignment system.
Consequently, the fundamental knowledge obtained as feedback in the childcare field includes: 1）In infant care, the assignment system is indispensable for ensuring children’s sense of security, as it is based on responsive interactions with specific caregivers. 2） In practicing the assignment system, caregivers must share a flexible perspective that considers the individual circumstances of each child, ensuring a secure living environment and promoting healthy physical and mental growth. Additionally, the assignment system supports children in the nursery and connects to childrearing support at home.本研究は、乳児期の保育に採り入れられている担当制の意義を保育所保育指針改定の変遷から検証し、保育現場に還元するための基礎的知見を得ることを目的とした。厚生労働省：社会保障審議会児童部会保育専門委員会での議事録、議事要旨、資料等を対象に、担当制に関連する記述部分を中心に考察した。
その結果、保育現場に還元するための基礎的知見として、１）乳児保育における担当制は、特定の保育者との応答的な関わりが基盤となり、子どもに安心を保障するために欠かせないものであること。２）担当制の実践に際しては、その形態や方法にとらわれることなく、個々の子どもの姿に応じた柔軟な視点から、子どもが安心できる生活、心身ともに健やかな成長ができるための関わりを保育者間で共有していくことの必要性が得られた。また、担当制は園での子どもの育ちを支えるだけではなく、家庭での育ちも見据えた子育て支援にも繋がることが示唆された。journal articl
重症心身障害児者の小児期医療から成人期医療への移行期における看護
Get PDFapplication/pdfThe purpose of this study was to clarify the current situation of nursing care and practice for patients with severe motor and intellectual disabilities during their transition from pediatric to adult medical care and to determine the implications for better transitional medical care. Semi-structured interviews were conducted with six nurses who had experience in nursing practice for patients with severe motor and intellectual disabilities during their transition from pediatric to adult medical care. The results were analyzed by using a qualitative synthesis method（KJ method）and integrated into six final labels. The labels extracted were: “Nurses’ feeling of difficulty: incompatibility between care adhered to by the patient’s family and professional care,” “Nursing care utilizing nurses’ expertise: nursing care that lessens the family’s persistence,” “Nursing care that gets back to the basics of nursing: communities’ awareness and strength of will to accept nursing care,” “Best medical care and requirements for transitional medical care: roles played by governments to enable information integration in the entire community,” “Training of inexperienced nurses: development of systems for the learning of individualized nursing care broadly to address individual patients’ lives and needs,” and “Readiness for transition of care at an early stage: development of a consultation system for both patients’ families and doctors.” Important challenges are the development of an information-sharing system and the provision of transitional medical care for children and adults with severe motor and intellectual disabilities with the support of the entire
community. These solutions need to be based on the training of inexperienced nurses and readiness for the transition of care at an early stage.本研究は、重症心身障害児者の小児期医療から成人期医療への移行期の看護と実践の現状を明らかにし、より良い移行期医療につなぐための示唆を得ることを目的とした。重症心身障害児者の小児期医療から成人期医療への移行期に看護を実践した経験をもつ看護師６名に半構造化面接を行い、質的統合法（KJ法）により分析した。６枚の最終ラベルに統合され、【看護師の苦手意識：家族がこだわるケアと専門的なケアが相入れられない困難さ】 、【看護職の専門性を活かす看護：家族のこだわりをとかすケア】、【看護職の原点に立ち戻ろうとする看護：地域で引き受けようとする強い意志の自覚】、【最善の医療と移行期医療に向けた要件：地域全体で情報統括できる行政役割の発揮】、【経験のない看護師の育成：個別性の大きい看護を学べる体制づくり】、【早期からの移行準備：家族も医療者も相談できる体制づくり】が抽出された。課題として、経験のない看護師の育成と早期からの移行準備、そのためには情報を共有できるシステムづくりと地域全体で重症心身障害児者の移行期医療を支えていくことが重要である。journal articl
